2024 WIN Mentor Application
Personal Information
Applicant Name
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First Name
Last Name
Business or Organization Name
Job Title
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tell Us About Yourself
Briefly describe your professional and educational background. Please include your current role and responsibilities. Additionally, please list any volunteer roles or boards you currently serve on.
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Please share some of your hobbies/interests.
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Leadership and Mentorship
Have you previously served as a mentor in any capacity? If yes, please provide details.
Which of the following areas of expertise best apply to you? (Please select 3-5)
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Leadership Development
Industry-Specific Knowledge & Insight
Career Advancement & Goal Setting
Community Engagement & Service
Networking & Relationship Building
Conflict Resolution & Problem-Solving
Time Management & Organization
Technology Trends & Digital Skills
Communication Skills (Verbal & Written)
Financial Literacy & Planning
Wellness & Stress Management
Work-Life Balance
Entrepreneurship & Business Development
Innovation & Creative Thinking
Personal Branding, Marketing & Sales
Diversity, Equity & Inclusion Awareness
Other
Are you willing to speak at a quarterly WIN meeting if asked? Topic would be pulled from areas of expertise listed above?
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Yes
No
Program Specific Questions
How do you believe mentorship can positively impact women in our business community?
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Please check the boxes below to acknowledge that you understand the WIN program requirements & expectations (if selected to participate).
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If selected for WIN, I understand that I am financially responsible for the program fee ($99/mentors; $59/mentees)
I will attend quarterly WIN meetings
I will have 1:1 meetings with my mentor/mentee 6-8 times throughout the year
I will attend the Chamber's Women in Business Luncheon (2025)
Chamber Involvement
How have you been involved with the Murray-Calloway County Chamber of Commerce? (Membership, program participation, events attended, committees joined, etc.)
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Personal Reference
Please share the contact information of one personal reference NOT associated with your business or organization.
Personal Reference Name
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First Name
Last Name
Personal Reference Email
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example@example.com
Personal Reference Phone Number
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Please enter a valid phone number.
Relation to Applicant
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Headshot & Bio
If selected to participate in WIN, we will use your headshot and bio in various program materials.
Please upload your professional headshot or a high resolution photo of yourself.
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Please provide a short bio to be used in program materials (500 words or less).
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Other
Please select your t-shirt size (adult unisex shirts)
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Small
2XL
Medium
3XL
Large
Other
XL
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